.beta.-lactone alkylene carboxylic acids are known compounds which have antihypercholesterolemic activity. The preparation of such compounds is described in copending patent application Ser. Nos. 07/021848, 07/053646 and 07/053774, now U.S. Pat. Nos. 4,847,271, 4,816,477 and 4,806,564, respectively.
Diabetic ketoacidosis is a condition observed in uncontrolled diabetic patients resulting in increased production of acetoacetic acid and .beta.-hydroxybutyric acid. While an insulin dependent (Type I) diabetic patient may also have high insulin levels the ketoacidotic state must be differentiated from insulin shock. Diabetic ketoacidosis is indicated in a diabetic patient by changes in sensorium such as confusion or coma; air hunger, rapid deep breathing in an attempt to compensate for metabolic acidosis; a fruity acetone odor on the breath; nausea and vomiting; possibly abdominal tenderness; extreme thirst and dry mucous membranes reflecting water depletion; and rapid weight loss. Diabetic ketoacidosis can be a very serious and even life threatening complication of diabetes and if not rapidly attended to can lead to death. Treatment of ketoacidosis can involve IV sodium bicarbonate which may result in saline overload in severe cases, and a too rapid rise in carbon dioxide level can result in an electrolyte imbalance, a dulling of the senses, coma or death. Thus, a more satisfactory treatment of ketoacidosis would be a most welcome addition to the armamentarium available in the successful management of a diabetic patient.
In addition to being a complication of diabetes management, ketoacidosis can also occur as a result of renal failure, the ingestion of exogeneous poisons such as ethylene glycol, salicylates, methanol, paraldehyde and the like, and during a gastrointestinal alkali loss such as during severe diarrhea, and with ileostomy and colostomy therapy. Treatment is similar to that used in diabetic ketoacidosis and is somewhat simplified since the simultaneous management of diabetes is not involved, however, the treatment still suffers from the same disadvantages and possible side effects which may be severe.
The instant invention is a significant improvement in the management of a ketoacidotic emergency.